Share Your Meningitis or other Vaccine preventable Story

Tell us your Angel Story. By filling out and submitting the form below you declare you have the right to tell the story and give Meningitis Angels the right to publish, distribute and use your story and photos as needed to educate all through our web site, brochures, videos and etc. We will make every effort to make sure your stories are not taken or used by those not affiliated with Angels.

Rules/Instruction for Submission

You must be 18 years old to submit or have parents or legal guardian permission.

You must have the legal right to write and submit the story.

Please use Arial type and DO NOT USE ALL CAPS, Bold Print and write in black ink.

Do not put on colored or printed back grounds.

Do not use names of hospitals or medical staff in your story. You can use words such as ER, local hospital etc.

If your child is an Earth Bound Angels (survivor) submit photo at the time of meningitis and now.

Photos need to be clear and close up if possible and submitted in Jpeg form.

Thank you for sharing your stories. It is when we share them that other lives might be save.

Share Your Story

Name *

First

Last

Phone Number *

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-

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Upload Photo *

Max file size: 20MB

Upload Photo *

Max file size: 20MB

Relationship to Angel *

SelfParentChildSibblingOther

Type of Bacterial Meningitis *

MeningococcalPneumococcalHiBOther Explain

Age at time of illness. *

Under 1 years of age Age 1-5Age 5-10Age 10-15Age 15-20Age 21-2526-3031 +